Types of Anesthesia
As we all know, any never-before-experienced event can cause a certain amount of anxiety and even fear within us; and, dental procedures are no exception to this rule. Many times the most common concern is: will I experience pain during my dental procedure? Fortunately, modern anesthesia technology now makes it possible to perform even complex surgeries in the dental office (rather than in the hospital) with little or no discomfort to the patient. In cases involving dental surgery, local anesthesia that numbs the surgical area (Novacaine) is used either by itself or in combination with one or more of the following: nitrous oxide (sometimes called "laughing gas"); oral pre-medication; intravenous "IV" sedation (also known as "twilight sleep" or conscious sedation); or, general anesthesia/deep sedation for relaxation. In fact, many patients report that their surgeries were remarkably pain- and anxiety-free!
During his anesthesia residency, Dr. Starck received extensive training in all levels of dental sedation, including the administration and management of general anesthesia/deep sedation. Prior to your surgery, you can expect Dr. Starck to give you a complete review and description of the specific types of anesthesia you will receive. There will also be time to ask any questions you may have or to express your concerns. And, remember...when it comes to anesthesia, the more you know, the less you will have to be anxious about.
Types of Anesthesia |
Will it Cause Amnesia? |
Will I Need An Escort Home? |
Must I fast prior to treatment? |
Nitrous Oxide ("Laughing Gas") |
Slightly Successful |
No |
No |
Oral Pre-medication |
Moderately Successful |
Yes |
No |
Intravenous "IV" Sedation |
Very Successful |
Yes |
Yes |
General Anesthesia |
Very Successful |
Yes |
Yes |
Local Anesthesia
Local anesthesia, also commonly known as Novacaine, is used during most dental procedures. This medication is administered as an injection designed to temporarily prevent the teeth nerve fibers from transmitting impulses, thereby numbing the area. The local anesthesia is the only type of anesthesia, which when used alone, will completely eliminate pain. It is possible, however, to combine local anesthesia with various types of conscious sedation techniques to further reduce your awareness and anxiety with the procedure.
Nitrous Oxide
Nitrous oxide, or "laughing gas," is the lightest form of conscious sedation. It is administered by breathing through a nasal mask. It has several very appealing properties. First, it is very short acting and is completely eliminated from the body minutes after turning it off, thereby allowing the patient to leave the office without an escort because there is no hang-over effect. Secondly, nitrous oxide can be patient regulated. If you want to feel more of its effects, you simply breath more frequently and deeply. Conversely, if you breathe through your mouth, you will feel less of its effects. Finally, the last appealing property is the cost. In most cases, there is little or no cost associated with the use of nitrous oxide. The big drawback to nitrous oxide is that even at its highest level of effectiveness, it is only minimally effective at reducing awareness and anxiety. Although its effects vary from patient-to-patient, most patients feel nitrous oxide "just takes the edge off."
Oral Pre-Medication
Oral pre-medication (or pills) are the next step up in the conscious sedation spectrum. Many different medications can be used, with Valium, Halcion, and Ativan being some of the most common ones. The advantages to oral pre-medication are that it is more effective than nitrous oxide, and it is also very inexpensive to administer. The patient will usually take the medication a half hour to one hour prior to the appointment, and the duration of the effects will vary. But, in all cases, the patient must have an escort both to and from the office. Although more effective than nitrous oxide, the effectiveness and onset of action are unpredictable.
Intravenous "IV" Conscious Sedation
Intravenous sedation, also known as "twilight sleep" or conscious sedation, will put you in a safe, relaxed, and comfortable state throughout your surgery. It is the most effective means of reducing awareness and anxiety for dental procedures. It is administered through an intravenous line (IV), and is therefore much more predictable in terms of effectiveness due to the quick onset of action. Although the patient is technically conscious throughout the procedure, in most cases, they will be completely unaware of the dental procedure. The disadvantage of conscious sedation is, of course, the increased cost and the need for an escort home after the procedure. But, for the patient who wants to be "the most" comfortable during the procedure, it is certainly the best way to go.
General Anesthesia (Deep Sedation)
Patients can "sleep" through their dental surgery with the help of IV deep sedation/general anesthesia. Oral and maxillofacial surgeons are licensed anesthetists--trained and certified to provide both moderate and deep sedation in the office and hospital settings. In order to maintain the highest possible standards in patient safety, Dr. Starck participates in many hours of continuing education on the subjects of general anesthesia and moderate sedation each year. His assistants are trained in anesthesia assisting, and both Dr. Starck and his team are certified in basic life support and in advanced cardiac life support.